Condominium proxy forms 2026

1. Click ‘Get Form’ to open the condominium proxy form in the editor.
2. Begin by filling out your information in the designated section. Ensure you provide your full name, date of birth, last four digits of your Social Security number, email address, street address, city, state, zip code, phone number, and primary physician's name.
3. Next, complete the patient’s information section. This requires similar details as yours: their full name, date of birth, last four digits of their Social Security number, email address, street address, city, state, zip code, phone number, and primary physician's name.
4. Review the MyChart Terms and Agreement carefully. Make sure you understand each point regarding confidentiality and responsibilities before proceeding.
5. Sign the form in the designated area as the proxy. Include your relationship to the patient and date of signing.
6. The patient must also sign below your signature to authorize access. They should include their relationship to you and date of signing.
7. Once completed, save your form and choose to either fax it directly or drop it off at the physician’s office as instructed.

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